A host of diseases or disorders, such as, for example, Hirschsprung's disease and, anismus (also known as spastic pelvic floor syndrome, anal sphincter dyssynergia, pelvic floor dyssynergia, dyssynergic defecation and paradoxal puborectal contraction) may cause difficult or uncontrollable defecation. Diagnostic techniques for identifying these, and similar, disorders may involve a simple physical examination by a trained professional. Oftentimes, however, a more invasive and involved process is required.
For example, procedures such as anorectal manometry, conventional and high-resolution anorectal manometry (ARM) or mano-defecography may be used to evaluate the functioning of the anal canal. These techniques may be performed by inserting a probe into the anal canal and measuring the pressure exerted by the sphincter muscles that ring the canal. Anal pressure that is higher than normal may be related to constipation, while anal pressure that is too low may cause fecal incontinence. Additionally, abnormal reflexes in the rectum may signal certain congenital or infectious diseases associated with constipation. Measurements made by the probes at different points in the rectum and anal canal may help locate any problem in the functioning of the anorectal muscles or nerves.
Appropriate probes for use with these techniques are known in the prior art and include, for example, Sierra Scientific Instruments' ManoScan™ anorectal catheters and probes, as well as the probes described in, for example, U.S. Pat. No. 7,944,008, entitled SUSPENDED MEMBRANE PRESSURE SENSING ARRAY.
Current practice of the above techniques often requires two or more technicians: one technician to operate the electronic workstation for the collection of data, and another technician to hold the probe in place during the procedure. Other activities of the procedure may be done by a technician, including insertion of the probe, inflation of an intrarectal balloon, which is part of the catheter assembly, training the patient to perform specific maneuvers, and removal of the probe after data are collected.
Currently, most of the procedures are performed while the patient is in the left lateral decubitus position (i.e., lying laterally on the left side). However, this position does not represent normal daytime activity and is especially not representative of a normal body position during defecation. Performing the procedures in this unnatural position may lead to non-representative (unreliable) responses to specific test maneuvers, such as, for example, “Bear Down” or “Attempted Defecation” maneuvers, because of the unnatural posture and perhaps because of patient self-consciousness about the possibility of soiling the examination environment (e.g., an examination table).
As such, there is a need in the art to eliminate non-representative responses to test maneuvers and to allow for more natural patient positions other than the left lateral decubitus position, and reduce the need for technician involvement, including the possibility of reducing the number of required technicians to one.